NPI | 1790235737 |
---|---|
Former Name | KAYLEE JOERGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5377405121) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016036421) |
Enumeration Date | 2016-10-13 |
Last Update Date | 2017-04-26 |